| Code | Description | Price | Price Type | Last Updated |
|---|---|---|---|---|
| 99211 | OP VISIT LEVEL 1 EST | $336 [source] | gross_charge | 2 weeks ago |
| 99212 | OP VISIT LEVEL 2 EST Other Outpatient | $566 [source] | gross_charge | 2 weeks ago |
| 99213 | OP VISIT LEVEL 3 EST | $665 [source] | gross_charge | 2 weeks ago |
| 99214 | OP VISIT LEVEL 4 EST | $948 [source] | gross_charge | 2 weeks ago |
| C1713 | IMPL SPN KIT 2LVL CSTM | $64,000 [source] | gross_charge | 2 weeks ago |
| C1725 | CATH BLN PRPF 80MM 150CM | $28,007 [source] | gross_charge | 2 weeks ago |
| C1776 | INSERT KN POLY SEG SZB | $29,128 [source] | gross_charge | 2 weeks ago |
| C1821 | IMPLNT SPN 8MM | $11,200 [source] | gross_charge | 2 weeks ago |
| C1874 | STENT AOR 24F 37MM 20CM | $64,000 [source] | gross_charge | 2 weeks ago |
| C1876 | STENT INTRCR 4MMX17MM | $23,920 [source] | gross_charge | 2 weeks ago |
| V2632 | LENS IOL +21.25 DIOP | $2,190 [source] | gross_charge | 2 weeks ago |
| V2787 | LENS IOL 0 D +19.5 DIOP | $990 [source] | gross_charge | 2 weeks ago |